Today we have a guest blog from Rozalyn Moore, DPT, owner of ReKinetic Physical Therapy & Wellness. Rozalyn provides insightful information about knee pain and treatment. Get her video on 5 knee exercises you can start today!
Osteoarthritis (OA) can be defined as a complex joint problem. OA usually occurs due to combinations of factors such as obesity, muscle weakness causing changes in walking, trauma, aging, or metabolic changes. There is high cost to the management of OA, both is personal pain and in healthcare dollars.
A diagnosis of OA does not mean bone on bone and it does not mean wear and tear or progressive joint disintegration or decay. The joint is not destined to get worse and it does not always require surgical intervention. Only 8-11% of all cases actually require joint replacement surgery. It is important to know that and MRI or radiographs do not change the clinical management of OA. Often imaging does not correlate with symptoms and signs and may place the notion of hopelessness in a patient’s mind.
There are non-surgical treatments that should be attempted before considering surgery. Treatments include lifestyle modifications such as an anti-inflammation diet and weight loss, physical therapy, daily activity, and injections such as hyaluronic acid (HA), corticosteroids (least desirable), prolotherapy and platelet-rich plasma (PRP) injections.
PRP is plasma that contains three- to five-times more platelets than whole blood. The platelets in PRP contain numerous proteins which aid in healing and in the growth of new cells. With more protein in the joint space, OA progression may potentially be slowed or paused. PRP is created is by taking blood from the patient, mixing it, and then re-injecting it into the patient’s joint space.
First, the research is lacking due to the inconsistency among PRP preparation, which makes it ineffective for use in clinical trials. Secondly, there is little research on long-term effects of PRP. And lastly, the cost can be high, and most insurance companies will not cover PRP injections (out-of-pocket costs range from $500 to $2,000 per injection). This can limit the number of people who can or want to afford it.
In a study comparing PRP to corticosteroid injections, PRP provided superior pain and symptom relief for patients with OA as well as significantly improved quality of life. Cortisone often is short lived and can cause more harm than positive outcome.
The program is guided by a Doctor of Physical Therapy and backed my science. The program is 12 weeks long with 5 one-one or small group consultations, via video-conferencing (HIPAA complaint Google Meetings). The PEAK program training modules teach management of knee OA with education, exercises, diet changes and activity guidelines to help you decrease the snap, crackle pop, walk with less pain and improve your activity level.
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Southworth, T., Naveen, N., Tauro, T., Leong, N., Cole, B. (2019). The Use of Platelet-Rich Plasma in Symptomatic Knee Osteoarthritis. The Journal of Knee Surgery. 32:37-45.
Kellum, E. (2020). Virtualsummit